How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $186.21 Median $1,862.09 Typical High $5,623.41 | Facility | None | $186.21 | $1,862.09 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $338.84 | Professional | None | $186.21 | $234.42 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $354.81 | Professional | None | $194.98 | $275.42 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $1,479.11 | Facility | None | $229.09 | $229.09 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,659.59 | Facility | None | $407.38 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $457.09 | Professional | None | $218.78 | $281.84 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $2,344.23 | Facility | None | $588.84 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $489.78 | Professional | None | $218.78 | $316.23 | $489.78 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $426.58 | Professional | None | $190.55 | $269.15 | $426.58 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $117.49 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $37.15 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $141.25 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $165.96 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $131.83 | $165.96 | $181.97 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 29th of 51
$295
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.